Department of Health » Payment by resultshttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health
Public health, adult social care, and the NHSWed, 04 Jan 2012 14:27:26 +0000enhourly1https://webarchive.nationalarchives.gov.uk/20120104183012/http://wordpress.org/?v=3.2.1Payment by Results – road test the 2012-13 packagehttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-2012-package/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-2012-package/#commentsThu, 15 Dec 2011 12:55:55 +0000tbykowskihttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=73631Read more → - Payment by Results – road test the 2012-13 package]]>The Payment by Results (PbR) road test exercise provides an opportunity for the NHS to test out the new tariff, and supports the planning process. The focus of the road test is to gather comments on the draft 2012-13 PbR guidance and PbR code of conduct.

If you would like to submit feedback on the draft guidance or code of conduct, please complete the road test response proforma and return it no later than Friday 20 January 2012 to: PbRComms@dh.gsi.gov.uk

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-2012-package/feed/0Update to Best Practice Tariffshttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/bpt-update/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/bpt-update/#commentsTue, 13 Dec 2011 15:27:30 +0000tbykowskihttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=68221Read more → - Update to Best Practice Tariffs]]>Best Practice Tariffs (BPT) represent one of the enablers for the NHS to improve quality, by reducing unexplained variation and universalising best practice. With best practice defined as care that is both clinical and cost effective, these tariffs will also help the NHS deliver the productivity gains required to meet the tough financial challenges ahead.

The aim is to have tariffs that are structured and priced appropriately both to incentivise and adequately reimburse providers for the costs of high quality care.

There is no one definition of what best practice looks like. A specific model will be developed for each of the service areas, each tailored to the characteristics of clinical best practice in that area, as well as the availability, quality and flow of data.

Set out below are the current Best Practice Tariffs that are in place for 2011-12 and a list of new service areas which are being considered for Best Practice Tariffs in 2012-13.

If you would like to be involved in the development of these tariffs then please get in touch via PbRcomms@dh.gsi.gov.uk

Best Practice Tariffs carried forward from 2010-11

Cataracts

In cataract treatment, an important element of best practice is to treat patients in a joined-up and efficient way, by carrying out all assessments before surgery at the same time, operating as a day case procedure in all but exceptional cases, and then carrying out all follow-up assessments on one day around two weeks later. This approach is preferred by patients as they do not have to spend unnecessary time waiting for appointments. This also provides a model of care that is more efficient and better value for money.

Cholecystectomy

Cholecystectomy is the removal of the gall bladder. This Best Practice Tariff has been developed to encourage this procedure to be carried out using key hole surgery in a day case setting where clinically appropriate. This should help to provide a service that is not only more efficient but also provides a better experience for the majority of patients.

Fragility hip fracture

For patients with a fragility hip fracture, care needs to be quickly and carefully organised to ensure the most positive outcomes are achieved. Six clinical characteristics of best practice reported through the National Hip Fracture Database have been identified. The BPT consists of a base tariff, with an additional payment if these characteristics of best practice have been met.

Stroke care

Patients presenting with symptoms of stroke need to be assessed rapidly and treated in an acute stroke unit by a multi-disciplinary clinical team which will fully assess, manage and respond to their complex care needs, including planning and delivering rehabilitation from the moment they enter hospital, and maximise their potential for recovery. The Best Practice Tariff consists of a base tariff with two additional payments if patients:

are admitted directly to, and spent the majority of their time in, an acute stroke unit

undergo initial brain imaging within an appropriate timeframe.

New Best Practice Tariffs introduced in 2011-12

Adult renal dialysis

This Best Practice Tariff aims to encourage the adoption of clinical best practice with respect to vascular access for haemodialysis where there is clear clinical consensus. As part of the Best Practice Tariff programme, we are introducing a mandatory currency with mandatory transition from local prices to national tariff for adult renal dialysis for patients with chronic renal failure.

Day case procedures

The cholecystectomy best practice day case model has been extended to cover a range of procedures. These procedures are:

breast surgery

hernia repair

orthopaedic surgery

urology.

These procedures have been selected on the basis of clinical consensus that, where clinically appropriate, these procedures can be carried out in a day case setting without the loss of efficacy.

Interventional radiology

Interventional Radiology (IR) offers an alternative to open surgery for a range of procedures. Where clinically appropriate, less invasive procedures such as interventional radiology facilitate decreased lengths of stay, leading to lower unit costs for providers and commissioners, and improved patient experience. Currently the Best Practice Tariff programme covers two IR procedures:

endovascular aortic repair (EVAR)

uterine fibroid embolisation.

Paediatric diabetes

Building on the introduction of non-mandatory prices in 2010-11, in 2011-12 we are encouraging best practice in paediatric diabetes follow-up outpatient attendances as a prelude to introducing a pathway Best Practice Tariff in 2012-13. To incentivise best practice, the follow-up tariff will attract a non-mandatory additional payment per follow up clinic consultation provided certain criteria are met.

Primary total hip and knee replacement

A Best Practice Tariff has been designed for elective primary total hip and knee replacements to incentivise best practice in the clinical pathways of patients undergoing these procedures. The pathway includes the pre-operative assessment, care during the hospital admission and immediate post discharge including outreach care. There is an expectation based on a range of publications that utilisation of such pathways should improve the patient experience and satisfaction, reduce lengths of stay and shorten post-operative rehabilitation. The Best Practice Tariff only applies to the admitted patient care element to encourage enhanced recovery.

Transient ischaemic attack (TIA / mini stroke)

A tariff for the timely and effective outpatient systems for treating patients with TIA. The Best Practice Tariff rewards providers already meeting minimum best practice whilst acting as an incentive for provision of best practice where it does not currently exist.

Ambulatory care

The aim is to promote management of emergency conditions on a day case basis adopting an ambulatory care pathway, building on the short stay emergency adjustment in the current tariff structure. Proposal is to apply this approach for a number of conditions including deep vein thrombosis and pulmonary embolism.

Day case setting

We expect to extend the number of procedures covered by the Best Practice Tariff approach to include tonsillectomy and septoplasty.

Outpatient setting

A similar approach to incentivising day case activity, but with the aim of shifting activity into the outpatient setting. The proposal is to extend this approach to procedures including female sterilisation, diagnostic hysteroscopy and diagnostic cystoscopy.

Home haemodialysis and assisted automated peritoneal dialysis

Building on the adult renal dialysis tariff introduced in 2011-12, the aim is to promote greater choice for patients of home therapies for dialysis.

Evaluation of the 2010-11 tariffs

The payments by results (PbR) team have commissioned an evaluation of Best Practice Tariffs to help evaluate the policy and inform decisions about how to develop the policy in the future. The aim of the research is to provide a national picture containing structured qualitative and quantitative information regarding the impact of Best Practice Tariffs in England.

Initial findings have been presented to the PbR team and will inform development of Best Practice Tariffs in 2012-13. A final report due in the autumn and will be made available via the PbR website.

Query process

NHS trusts or primary care trusts should contact strategic health authority (SHA) PbR leads in the first instance with queries, outstanding and new. If the query can still not be answered, then SHA PbR leads will contact the Department of Health for clarification/ answers. This is appropriate for both emails and telephone calls.

Gateway number: 16599

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/bpt-update/feed/0Forensic and Challenging Behaviour Sub Group Report publishedhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/fcb-report/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/fcb-report/#commentsFri, 02 Dec 2011 10:39:55 +0000webteam-rmhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=69371Read more → - Forensic and Challenging Behaviour Sub Group Report published]]>This report summarises the work undertaken by the Forensic and Challenging Behaviour Product Review Sub Group over the past 12 months. It builds upon two strands of work previously undertaken:

the first being the development of a clinically derived set of descriptors piloted by a group of London Medium Secure Units and

the second being a modification of the mental health clustering tool (MHCT) and the 21 Clusters mandated for use in working aged adult and older peoples services, piloted by two trusts in the north east of England.

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/fcb-report/feed/0PbR Quality and Outcomes Indicators Reporthttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-indicators-report/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-indicators-report/#commentsFri, 02 Dec 2011 10:01:23 +0000webteam-rmhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=69391Read more → - PbR Quality and Outcomes Indicators Report]]>This report describes the progress made to date in responding to the request from the National Project Board for Mental Health Payment by Results (PbR) to develop an approach that ensures quality indicators and outcome measures are an integral part of the PbR process, and in particular that they encourage the correct incentives.

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-indicators-report/feed/0PbR MH Factsheet No 18 November 2011https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-mh-factsheet-18/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-mh-factsheet-18/#commentsThu, 01 Dec 2011 14:45:42 +0000webteam-rmhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=68971Read more → - PbR MH Factsheet No 18 November 2011]]>This factsheet provides a short update on recent development work in the commissioning of mental health (MH) services.

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/12/pbr-mh-factsheet-18/feed/0PbR update – October 2011https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/pbr-update/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/pbr-update/#commentsFri, 28 Oct 2011 09:29:51 +0000webteam-rmhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=55741Read more → - PbR update – October 2011]]>Welcome to the seventh update from the Department’s Payment by Results (PbR) team. The purpose of these updates is to keep colleagues in the NHS and other interested parties informed throughout the year about our team’s work.

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/pbr-update/feed/0Draft mental health PbR guidance for 2012-13 and update on other PbR issueshttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/draft-mental-health-pbr/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/draft-mental-health-pbr/#commentsTue, 18 Oct 2011 15:34:00 +0000webteam-nphttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=50281Read more → - Draft mental health PbR guidance for 2012-13 and update on other PbR issues]]>David Flory, Deputy NHS Chief Executive, has written to the Health Service, and Directors of Adult Social Services, about publication of an early draft of the PbR guidance for 2012-13 for working age adults and older people.

Although such draft guidance is usually published in November or December each year, those involved in the provision and commissioning of adult mental health services felt it would be helpful for guidance to be issued earlier this year in light of the large scale change that is likely to take place next year. A final version of the guidance will be issued at the end of the year.

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/draft-mental-health-pbr/feed/0Information on plans for Payment by Results in 2012-13https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/pbr-2012-13/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/pbr-2012-13/#commentsThu, 06 Oct 2011 10:48:14 +0000webteam-rmhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=44481Read more → - Information on plans for Payment by Results in 2012-13]]>David Flory, Deputy NHS Chief Executive, issued a letter today which provides information on plans for Payment by Results (PbR) in 2012-13. These plans include an expansion in the scope of PbR into areas such as adult mental health, and a further increase in the coverage of best practice tariffs. He also highlights the publication by the Department of Health of a draft of the mental health PbR guidance for 2012-13.

This draft guidance in intended for all NHS organisations providing mental health services in preparation for 2012-13 and all commissioners of mental health services, to test at an early stage whether we are giving providers and commissioners enough information to set the framework for their contractual discussions, based on the new currencies.

A final version of the PbR guidance will be published later this year.

]]>https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/10/pbr-2012-13/feed/0Guide to payment by resultshttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/08/guide-to-payment/
https://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/2011/08/guide-to-payment/#commentsMon, 01 Aug 2011 14:16:55 +0000webteam-ajhttps://webarchive.nationalarchives.gov.uk/20120104183012/http://www.dh.gov.uk/health/?p=13351Read more → - Guide to payment by results]]>The updated version of ‘A simple guide to Payment by Results’ provides an introduction for those who are new to the concept of Payment by Results. It reflects changes to Payment by Results arrangements for 2011/12.